America’s rising tide of drug overdoses, a symptom of deeper problems

Summary: America has a drug problem, a symptom some deeper sickness of our minds or souls. Sick people often ignore warnings that would allow them to respond and recover. So it is with nations. It’s time for us to ask what is wrong with America.

NIDA - National Overdose Deaths From all drugs

America is among the most drugged major nations in the history of the world. The data comes in with each month’s news (we’ll look at the horrific prescription drug use by children another day). For example — 17% of US adults report using prescriptions for psychiatric drugs in 2013 (mostly long-term use). “Adult Utilization of Psychiatric Drugs and Differences by Sex, Age, and Race” by Thomas J. Moore and Donald R. Mattison in the JAMA Internal Medicine, February 2017 (see the NBC News story about this).

But opioids are the killers. America consumes 85% of the world’s opioid production (natural and synthetic; see below).  The casualty toll is rising. See these sad graphs about Overdose Death Rates from the National Institute on Drug Abuse.

NIDA - National Overdose deaths from opioids

Photo of Fentanyl in a jar
A few grains of fentanyl (2 milligrams) is a lethal dose. Photo by AP/Cliff Owen.

Conclusions

Of the thousands of articles each year about America’s massive drug use, legal and illegal, few ask why we consume so much more drugs than other developed nations. Drugs are just the symptom for deeper problems (e.g., 20% of US adolescent girls had a major depressive episode in 2015).

We boast about America being exceptional, but these records should force reflection about what we have become. This is a symptom of a broken society — a warning we should not ignore. What has gone wrong with America?

China gets its revenge for the Opium War — on us.

In the mid-19th century the UK fought two wars with China over, among other things, the Brits right to import opium into China — the Opium Wars. Now the US, the heirs to British world hegemony, experience one of those moments of irony that make history so interesting — as China gives America ever more powerful designer drugs. See “Deadly chemistry” by Kathleen McLaughlin in Science, 31 March 2017 — “Underground labs in China are devising potent new opiates faster than U.S. and Chinese authorities can respond.” Excerpt…

“Fentanyl and its analogs are new faces of a worsening scourge. The United States consumes 85% of all the world’s natural and synthetic opiates, which in 2015 factored in 33,091 U.S. deaths, up more than 4000 from the previous year, according to the U.S. Centers for Disease Control and Prevention. Opioid overdoses have quadrupled since 1999. When average U.S. life expectancies for men and women edged downward last year, for the first time in decades, many health professionals blamed opiate abuse.

“The opium poppy is no longer the starting point for many of the opiates on the street. The new compounds, often sold mixed with heroin, originate in illicit labs in China. …

“Chinese labs began tweaking the fentanyl molecule, which is easy to alter for anyone with basic knowledge of chemistry and lab tools. By adding chemical groups, unscrupulous chemists have created new, unregulated variants, some of them even more potent than the original. …the chemical one-upmanship has deepened the opiate crisis, as new and nastier substances appear on the streets in places like Cincinnati. The fentanyl derivatives not only allow makers and dealers to elude law enforcement; they blindside public health authorities and make addiction even riskier. …

“Fentanyl crosses the blood-brain barrier with ease. It binds to opioid receptors and floods the brain with dopamine, which creates intense euphoria but also slows the heart and depresses breathing. For most individuals, a lethal fentanyl dose is about 2 milligrams—an amount so minuscule that in a test tube it looks like a few grains of salt clinging to the glass. Carfentanil is 100 times stronger, making it about 10,000 times more potent than morphine. …

“China eventually banned methylfentanyl, driving down its production and pushing it deeper underground. Its crackdown on fentanyl and several analogs in 2015 led to a marked decline in those synthetic opiates in the United States, DEA says. And last month, after extensive negotiations with DEA, China added carfentanil and three more fentanyl analogs to its list of controlled substances.

Even before China scheduled carfentanil, the scourge had begun to fade in Ohio. …But a new threat has appeared. Traces of an unidentified fentanyl analog have cropped up in several batches from crime scenes. Hamilton County’s scientists will search for a molecular match, add it to the list—and hope the new wave is less deadly than the last.”

For More Information

For more about this problem see “Opioid Addiction: 2016 Facts & Figures” by the American Society of Addiction Medicine.

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10 thoughts on “America’s rising tide of drug overdoses, a symptom of deeper problems

    1. John,

      (1) Life is not like a sitcom. Problem-solving consists of phases. The first, and often the most difficult, is problem recognition. Then comes analysis, and only then comes describing alternative solutions.

      (2) Most of the solutions seen on ope-ed pages is insanely confident making stuff up, unsupported by any appropriate factual and analytical foundation.

      (3) “FM should demonstrate stronger opinions on what are the possible solutions.”

      I suggest you read more carefully. I recommend actions for the majority of subjects I discuss on the FM website.

  1. FM,

    Is there a relationship between the rise in opium production in Afghanistan and the opioid epidemic faced in the USA? Is it a coincidence that the country responsible for 90% of illicit opium is occupied by the USA?

    PF Khans

    1. PFK,

      Good question. I will confidently say “no” — based on faith, with no supporting evidence, hoping very much I’m correct.

      But there are oddities. This is part of the greater oddity that the US is to some degree in a culture war with some factions of fundamentalist Islam. So far we have overthrown or helped overthrow three secular regimes (Afghanistan, Iraq, Libya), all replaced by fundamentalist regimes — and are working to do so to a fourth regime. Historians will wonder if we were deranged, grossly incompetent, or all quite high (bringing us full circle back to today’s post).

  2. FM,

    I agree with your answer and your reasoning. At a certain point, though, the difference become grossly incompetent and actively malicious is quite small.

    PF Khans

    1. PFK,

      “difference become grossly incompetent and actively malicious is quite small.”

      Can you explain that? It looks like a big big big difference to me!

      The difference to the families wreck by drugs is small. The public policy response is quite different to the two situations, imo.

  3. FM,

    I suppose my focus was on the final outcome not on the public policy prescription.
    But I do think that in the United States, the difference between incompetency leading to great evil, and a more malicious intent to create evil and thereby profit from it (I’m assuming no Bond villians) is motivation. I think we can rule out our leaders actually being that incompetent. They’re well educated and elevated due to successes and rarely are they grossly incapable of doing the job with which they are tasked. They can miscalculate and misunderstand the situation but my experience with our government has me convinced that the vast majority of our leaders are motivated and competent.

    What my experience has shown me is that a great many of these competent leaders are easily led into planning on ‘hope.’ We ‘hope’ that this won’t happen so that we can do this other thing. They ‘hope’ that Syria’s president can be deposed without causing a power vacuum that encourages further fundamentalist success. They ‘hope’ that the drug trade problems will solve themselves or stay in Asia.

    Since I’m assuming they could address this problem if they wanted, the incompetency argument looks like a lack of desire to address the problem or a lack of empathy with its victims. But being incompetent in this manner and being malicious is now a matter of intent. Did you want your victims to suffer or did you do it because they’re not important enough to prevent their suffering? Can anyone but God really know what’s in a man’s heart? Our ability to adjudicate right reasoning for these outcomes is highly questionable, in my opinion. It relies on an honest person who is so convicted of their prior reasoning that they tell others of it. That’s not most people and it has nothing to do with competency.

    Hope that clarifies my thinking.

    PF Khans

  4. PF Khuns portrays citizens as helpless sheep, subject to every whim of officials and elites. Perhaps in his country that is the case. In countries such as the UK or US, the problem is a general lack of purpose resulting from a generally loose and neglectful upbringing during childhood. Young humans need certain boundaries and assurances at different stages of their development. Being raised by an Xbox, MTV, and social media does not supply those simple basics. Instead, children are barraged by nonsense and parasitical memes that serve a wide array of interested parties, other than the parents and children themselves. On arrival to adulthood, the lack of purpose manifests in several ways, most of them dysfunctional.

    This is not a conspiracy. It is instead blatant opportunism by multiple parties who are themselves in conflict with each other for market share and brain share. Nature abhors a vacuum, and thanks to neglect of parents, extended families, and communities, the brains of most children emerge into the world as a giant sucking vacuum.

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